Govt. of India Meeting of Health Secretaries Under the Chairmanship of Secretary (Health & Family Welfare) to deliberate on approved GoM proposal 31 st October, 2012 Directorate of National Vector Borne Disease Control Programme (Directorate General of Health Services) Ministry of Health and Family Welfare 1
Cabinet approval on 18.10.2012 for Prevention and Control of Japanese Encephalitis (JE)/Acute Encephalitis Syndrome (AES) as recommended by GoM 2
Goal Reduce morbidity, mortality and disability in children due to JE/AES. 3
Reported JE/AES Cases and Deaths 9000 30.00 8249 8000 7286 25.00 24.21 7000 23.09 No. of Cases and Deaths 6000 20.00 5167 4975 17.74 5000 CFR (%) 15.66 4110 15.00 14.62 3855 14.17 4000 13.14 2871 3000 10.00 2000 1169 1065 5.00 995 779 679 684 663 1000 0 0.00 2006 2007 2008 2009 2010 2011 2012 till Year 29.10.2012 Cases Deaths CFR 4
JE/AES 60 High Priority Districts Bihar 15 Districts CHAMPARAN WEST Uttar Pradesh 20 Districts SAHARANPUR CHAMPARAN EAST GOPALGANJ ARARIA MUZAFFARPUR SIWAN DARBHANGA SARAN KHERI SAMASTIPUR VAISHALI SRAWASTI BIHAR BAHRAICH PATNA SITAPUR BALRAMPUR HARDOI SIDDHARTHNAGAR MAHARAJGANJ NALANDA GONDA JEHANABAD KUSHINAGAR UTTAR PRADESH SANT KABIR NAGAR BASTI GORAKHPUR DEORIA JAMMU & KASHMIR NAWADA KANPUR(DEHAT) GAYA RAEBARELI MAU AZAMGARH BALLIA TINSUKHIA DHEMAJI HIMACHAL PRADESH DIBRUGARH PUNJAB CHANDIGARH LAKHIMPUR UTTARAKHAND SIBSAGAR HARYANA DELHI ARUNACHAL PR. UDALGURI SONITPUR JORHAT SIKKIM ASSAM RAJASTHAN UTTAR PRADESH GOLAGHAT ASSAM BARPETA NAGALAND BIHAR MEGHALAYA MANIPUR WEST BENGAL TRIPURA GUJARAT JHARKHAND MIZORAM MADHYA PRADESH CHHATTISGARH ORISSA DAMAN & DIU D&N HAVELI MAHARASHTRA Assam ANDHRA PRADESH DARJILING 10 Districts JALPAIGURI GOA KARNATAKA VILLUPURAM A&N ISLANDS PONDICHERRY TAMIL NADU TAMIL NADU KERALA LAKSHADWEEP DAKSHIN DINAJPUR MALDAH KARUR THANJAVUR THIRUVARUR WEST BENGAL West Bengal 10 Districts BIRBHUM MADURAI Tamil Nadu BARDHAMAN BANKURA 5 Districts HUGLI HOWRA PASCHIM MEDINIPUR 5
No. of districts under GoM – Assam TINSUKHIA DHEMAJI District under GoM- 10 DIBRUGARH LAKHIMPUR SIBSAGAR SONITPUR UDALGURI JORHAT ASSAM GOLAGHAT BARPETA 6
No. of districts under GoM – Bihar District under GoM- 15 CHAMPARAN WEST CHAMPARAN EAST GOPALGANJ ARARIA MUZAFFARPUR SIWAN DARBHANGA SARAN SAMASTIPUR VAISHALI BIHAR PATNA NALANDA JEHANABAD NAWADA GAYA 7
No. of districts under GoM – Tamil Nadu District under GoM- 5 VILLUPURAM TAMIL NADU KARUR THANJAVUR THIRUVARUR MADURAI 8
No. of districts under GoM – Uttar Pradesh SAHARANPUR District under GoM- 20 KHERI SRAWASTI BAHRAICH BALRAMPUR SITAPUR HARDOI SIDDHARTHNAGAR MAHARAJGANJ GONDA KUSHINAGAR SANT KABIR NAGAR UTTAR PRADESH BASTI GORAKHPUR DEORIA KANPUR(DEHAT) RAEBARELI MAU AZAMGARH BALLIA 9
No. of districts under GoM – West Bengal District under GoM- 10 DARJILING JALPAIGURI DAKSHIN DINAJPUR MALDAH WEST BENGAL BIRBHUM BARDHAMAN BANKURA HUGLI HOWRA PASCHIM MEDINIPUR 10
Objectives-(1) • Strengthen and expand JE vaccination in affected districts; • Strengthen surveillance, vector control, case management and timely referral of serious and complicated cases; • Estimate disability burden due to JE/AES, and to provide for adequate facilities for physical, medical, neurological and social rehabilitation; 11
Objectives-(2) • Provide fixed monthly compensation to families having children with disability due to JE/AES; • Increase access to safe drinking water and proper sanitation facilities to the target population in affected rural and urban areas. • Improve nutritional status of children at risk of JE/AES; • Carry out intensified IEC/BCC activities regarding JE/AES. 12
Participating Ministries • Health and Family Welfare • Drinking Water and Sanitation • Social Justice and Empowerment • Women and Child Development • Urban Development • Rural Development 13
Activities to be taken by Ministries/Departments Strengthening of Public Health Activities as per Model Action Plan • Model action plan including public health measures developed. • The model action plan envisages community based surveillance, entomological surveillance, vector control, and IEC/BCC capacity building involving community volunteers • This action plan to be implemented in 60 high priority districts of 5 states. 14
Activities to be taken by Ministries/Departments JE Vaccination in Campaign and Routine modes • Vaccination most effective tool available against Japanese Encephalitis • 109 districts covered under JE vaccination as part of Universal Immunization Programme (UIP). • 62 new districts to be brought under JE vaccination in phased manner • New areas will also be covered based on epidemiological evidence • The total Estimated Cost for Japanese Encephalitis- Campaign and Routine Immunization in 171 Districts is Rs. 200.71 cr. 15
Activities to be taken by Ministries/Departments Better Clinical Management of JE/AES Cases • Early detection of symptoms of by doctors helps in quick referral of serious cases to well-equipped hospitals. • For achieving above objective capacity building of medical and para-medical staff and adequate facilities at district hospitals essential. • 10 bedded well-equipped intensive care unit (ICU) in 60 priority districts to be established. • The total estimated cost for Establishment of Pediatric Intensive Care Unit at District Hospitals is Rs 549.21 cr. 16
Activities to be taken by Ministries/Departments Strengthening of Surveillance and Diagnostic Facilities • 54 JE surveillance and diagnostic centers already established. • For further strengthening the surveillance, 20 new sites in 5 states. • The total estimated cost for Estimated Cost for Establishing 20 New Surveillance Sites and Strengthening of existing 54 sites at Medical College/District Hospitals is Rs 13.54cr. 17
Activities to be taken by Ministries/Departments Physical Medicine and Rehabilitation • 30 to 40 per cent of surviving children suffer from physical and/or mental impairment. • For addressing above issue 10 physical medicine and rehabilitation centre to be established at identified medical colleges. • The centre will be equipped to provide specialized care to persons with loco-motor & neurological disorders with focus on reducing disability & handicap. • The total Establishing PMR Dept at 10 Identified Medical Colleges in 5 states is Rs 168.55 cr. 18
Activities to be taken by Ministries/Departments Establishing District Counseling Centres • Rehabilitation of the surviving disabled patients is an important component of the overall programme strategy • 10 medical colleges across 5 States have been identified for addressing this problem and for providing physical rehabilitation to AES/JE affected patients. • These patients as well as their parents/attendants need to be counseled as some of the post recovery sequelae involve, loss of speech and hearing, irritability, locomotor and behavioural disorder. • The total Establishing Counseling Centre at 60 District Hospitals in 5 States to Rs. 13.30 crores. 19
Activities to be taken by Ministries/Departments Monitoring, Supervision and Coordination • AES/JE problem in the country suggests a multi- pronged approach involving different Ministries for effectively talking the menace at the grass- root level. • The inter-Ministerial/departmental convergence requires an intensive monitoring, supervision and coordination at MOH&FW. • For this purpose a estimated cost of Monitoring Supervision and Coordination Rs .49.83 crores has been proposed. 20
Role of Responsibilities of other Ministries 21
Ministry wise Allocation Estimated Costs S. Ministry/ Department (Rs. In crore) No. 1. Ministry of Health and Family Welfare 1131.49 2. Ministry of Drinking Water and Sanitation DW - 750.23 Sani. – 1551.34 Total – 2301.57 3. Ministry of Housing and Urban Poverty 418.00 Alleviation 3. Ministry of Social Justice and Empowerment 9.19 4. Ministry of Women and Child Development 177.85 Total 4038.10 22
Activity wise Health Ministry Allocation for Prevention & Control of JE/AES Estimated Cost S. Sub-Component (Rs. in Crore) No. 1 Strengthening Public Health Activities in 60 districts 101.34 JE Vaccination 200.72 2 Establishment of Pediatric ICUs at 60 district 3 549.21 hospitals 4 Establishmentof 20 New JE/AES Surveillance Sites 13.54 5 Establishmentof PMR Dept. at 10 Medical Colleges 168.55 6 Establishmentof 60 District Counselling Centres 13.30 Research-Cum-Intervention Projects 35.00 7 Monitoring& Coordination 49.83 8 Total 1131.49
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